Individual
SHAWN LOCKRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
121 PULASKI RD, KINGS PARK, NY 11754-2539
(631) 455-9347
Mailing address
2401 QUARRYSTONE LN, MIDDLE ISLAND, NY 11953-1479
(631) 522-6975
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
019168
NY
Other
Enumeration date
11/02/2021
Last updated
05/16/2022
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